폐모세포종 : 1례보고 A Case Report

최영호,서홍주,임영혁,김정중,박성강,이석기,임진수,김은규 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.2

Pulmonary blastoma is a very rare primary neoplasm of the lung. We experienced a case of pulmonary blastoma in a 40 years old man. The mediobasal segmentectomy of the right lower lobe was performed. The patient was discharge on the postoperative days 6. There is no evidence of recurrence or metastasis on followup study during 7 months period after operation.

C형 간염의 병리조직학적 고찰

김형준,김재규,김미경,박중원,유병철,박실무 중앙대학교 의과대학 의과학연구소 1997 中央醫大誌 Vol.22 No.2

After the discovery of hepatitis C virus, several reports of histologic charcteristics of hepatitis C have been published. The aim of this study is to evaluate histopathologic features of hepatitis C for diagnostic significance. Needle biopsy specimens obtanied from the liver of 14 patients with hepatitis C were evaluated for the diagnostic significance. All patients had not any evidence of hepatitis B, and autoimmune and alcoholic liver diseases. The specimens were histologically evaluted based on previously reported features of hepatitis C such as bile duct damage, lymphocytes infiltration, steatosis and so on. According to the mode of transmission, sporadic infections were 12 cases, posttransfusion hepatitis and Ⅵ drug abuser was 1 case. The commonst finding was sinusoidal inflammatory cell activation, especially lymphocyte (86%). And lymphoid follicles or lymphocytes aggregates (65%), steatatosis (65%) were found. According to the activity of hepatitis, significant difference of pathologic features could not be proposed, but most histologic features were showned in CAH. In conclusion, all the histologic characteristics of hepatitis C such as sinusoidal cell activation, lymphoid aggregates, steatosis were observed in this study. But the further study of comparative histologic evaluation between hepatitis C and other hepatitis is needed. And also, comparative study with larger subjects for specific histopathologic findings according to the activity of hepatitis and epidemiologic cause in needed.

상부 조기 위암 환자의 복강경하 상부 위절제술 3례 경험

조규석,김형철,박경규,이문수,송옥평,임철완,신웅진,주종우,유기원 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Background : The reported incidence of early gastric cancer located in the upper portion of the stomach has been increasing with the recent advances in its diagnosis and screening. Recently, we have successfully performed laparoscopic assisted proximal gastrectomy and gastric tube reconstruction without pyloroplasty on three patients with early gastric carcinoma localized to the upper third of the stomach. We describe our modification of this procedure in this report. Method : After creating an surgical pneumoperitoneum, the stomach was mobilized using laparoscopic coagulating shears. Upper half of the greater curvature and three-quarters of the lesser curvature were then dissected along with regoinal D2 lymphadenectomy. This was followed by a 5 cm, longitudinal mini-laparotomy in the upper abdomen, and the construction of the exteriorized stomach with a gastric tube measuring 20 cm long and 4 cm wide. Reconstruction with an esophagogastrostomy was performed using a circular stapler. Result : No post-operative morbidity or mortality was observed in this small series of patients. The average operative time was 250 minutes (range 220-300 minutes), and the average blood loss was 150 ml (range 90-180 ml). The mean number of lymph nodes harvested during these laparoscopic proximal gastrectomies was 24 nodes (range 22-25 lymph nodes). The average postoperative hospital stays was 7.5 days (range 7-8 days). Conclusion : Our technique of laparoscopic assisted proximal gastrectomy and gastric tube reconstruction without phloroplasty offers a minimally invasive technique with the potential of impoving the post-operative quality of life patients with an early-stage proximal gastric cancer.

치성낭종과 낭종액에서 IL-1, TNF-α의 농도분포에 관한 연구

공형규,박동성,임성삼 大韓齒科保存學會 1999 Restorative Dentistry & Endodontics Vol.24 No.1

DSM-CC U-U 적합성 시험을 위한 시험열 생성

김영규,전기환,박용,백청호,최형진 강원대학교 정보통신연구소 2006 정보통신논문지 Vol.10 No.-

In these days, as rapid growth of multimedia industries and development of techniques, an effort to develop DAVIC(Digital Audio-Visual Council) systems which support multimedia services such as VOD(Video on Demand) and teleshopping is being done. Therefore it will be indispensable to establish a new conformance testing method related DAVIC system with respect to their standard specification. DSM-CC is a core part of DAVIC and adopts DSM-CC U-N for S3 information stream which plays a part in connection establishment and release of session and transmission layer, and DSM-CC U-U for S2 which operates user application of the system. In this paper, we propose a new conformance testing architecture and methodology based on scenario in order to test DSM-CC U-U which doesn't have any message sequences.

고출력 CW Nd:YAG 레이저를 이용한 CSP 1N 박판재 절단시 공정변수의 절단표면특성에 미치는 영향

안동규,김민수,이상훈,유영태,박형준 한국공작기계학회 2004 한국공작기계학회 추계학술대회논문집 Vol.2004 No.-

The objective of this research work is to investigate the influence of process parameters, such as power of laser, travel speed of laser and material thickness, on roughness and striation of the cut surface for the case of cutting of CSP IN sheet using high power Nd:YAG laser with continuous wave (CW). In order to find the practical cutting region and the relationship between process parameters on the roughness and the striation, several laser cutting experiments are carried out. From the results of experiments, the allowable cutting region and an optimal cutting speed for each cutting condition have been obtained to improve the quality of the cut surface. In addition, it has been shown that the surface roughness is related to the number of striation and depth of valley of the cut surface.

만성 신부전증 환자의 중중 고혈당에 따른 의식 변화 결정에 대한 연구

위형중,이창범,박성광,강성귀,임천규,박은주,윤경택,한상웅,안유헌,김호중· 대한신장학회 2000 대한신장학회잡지 Vol.19 No.6

이행성 협심증 환자에서 운동부하 심전도 검사

이정우,박형서,박용규,노상필,이유선,정승현,김보영,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

목적 : 관상동맥의 경련에 의한 이형성 협심증환자에 있어서 운동부하 심전도 검사의 결과는 매우 다양하다. 이에 저자들은 충남대학교병원 순환기내과에서 관상동맥조영술상 이형성 협심증으로 확진된 환자를 대상으로 운동부하 심전도 검사를 시행하여 이에 대한 결과를 연구하였다. 방법 : 1995년 1월부터 2002년 3월까지 흉통을 주소로 충남대학교병원 순환기 내과에 입원하여 관상동맥조영술을 시행하여 관상동맥의 내경이 50% 미만의 협착이 있고, 에르고노빈(ergonovine) 유발검사도 이형성 협심증으로 진단을 받은 233명중 운동부하 심전도 검사를 시행 받은 183명의 환자를 연구 대상으로 하였다. 운동부하 심전도 검사 결과의 판독시 발생할 수 있는 오류를 줄이기 위해서 운동부하 심전도 검사를 시행하기전 심전도상 ST분절의 상승(5예)이나 하강(8예)이 있는 경우 EH한 T파의 역위(19예)가 있는 32명의 환자를 제외한 총 151명의 환자를 대상으로 하였다. 운동부하는 Marquette사의 case 15 답차를 이용하였고, Bruce protocol에 따라 증상이 나타날 때까지 최대로 실시하였으며 각 stage 및 운동후의 혈압을 측정하고 12 유도 심전도를 기록하였다. 결과 : 1) 임상적 특성 - 내원시 임상 상은 안정형 협심증이 39예(25.8%), 불안정형 협심증이 103예(68.2%), 심근경색증이 9예(6.0%)이었다. 운동부하 심전도 검사 결과 양성 군과 음성군간에 있어서 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연 여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도, 연축의 수 등을 조사하였는 바 어떠한 인자들도 유의한 차이를 발견할 수 없었다. 2) 운동부하 심전도 검사 - 운동부하 심전도 검사를 시행 받은 151명의 환자중 음성인 경우는 134예(88.8%)이었고, 양성인 경우는 17예(11.2%)이었다. 양성 소견을 보인 환자들중 ST 분절의 상승이 4예(2.6%), ST 분절의 하강이 13예(8.6%)이었다. 3) 관상동맥조영술 - 관상동맥조영술상에서 혈관 경력 위치는 우관상동맥이 70예(46.1%), 좌전하동맥이 44예(28.9%), 좌회선동맥이 17예(11.2%)의 순으로 나타났다. 운동부하 심전도 검사상 ST 분절의 상승이 있었던 예중 Ⅱ, Ⅲ, aVF에서 ST 분절의 상승이 있었던 1예는 관상 동맥조영술상 우관상동맥에서 경련이 발생하였고, V2-V4에서 ST 분절의 상승이 있었던 2예중 관상동맥조영술상에도 좌전하행동맥에서 경련이 나타난 예는 1예이었으며 다른 1예는 좌회선동맥에서 경련이 나타났고, V5-V6에서 ST 분절의 상승이 있었던 1예는 관상동맥조영술상에도 좌회선동맥에서 경련이 나타났다. 운동부하 심전도 검사상 V5 또는 V6에서 ST 분절의 하강이 있엇던 13예중 6예(46.1%)는 관상동맥조영술상 우관상동맥에서 경련이 발생하였고, 3예(23.1%)는 좌전하행동맥에서, 1예(7.7%)는 좌회선동맥에서, 나머지 3예(23.1%)는 2개의 혈관이나 기타 분지에서 경련이 발생하였다. 결론 : 1) 이형성 협심증 환자는 운동부하 심전도 검사에서 11.2%의 양성소견을 보였다. 이중 ST 분절의 상승은 2.6%이었고, ST 분절의 하강은 8.6%이었다. 2) 이형성 환자중 운동부하 심전도 검사를 실시하여 음성을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 3) 이형성 협심증 환자중 운동부하 심전도 검사를 실시하여 ST 분절의 상승을 보이는 경우 다혈관 관상동맥질환이기 보다는 이형성 협심증일 가능성이 더 높다고 예측할 수 있을 것으로 생각된다. 4) 운동부하 심전도 검사 결과에 대한 당뇨병, 고혈압, 비만도, 총 혈청콜레스테롤치, 현재의 흡연여부, 병력상 운동시 흉통의 유무, 내원시 임상적 진단, 협착의 정도 등 어떠한 인자들도 3그룹(ST 분절의 상승, ST 분절의 하강, 음성)간에 유의한 차이를 발견할 수 없었다. 5) ST 분절의 상승 부위와 관상동맥조영술상 관상동맥의 연축이 일어나는 혈관과의 상관관계는 매우 높았다. No reports in the literature describe the results of exercise testings in a large number of patients with pure variant angina(coronary stenosis <50%) in Korea. In this report, We present the results of treadmil exercise testing in 151 patients with variant angina. 151 patients with angiographically proven coronary artery spasm underwent a treadmil exercise test. The clinical characteristics of variant angina patients classified according to ST-segment response to exercise were analyzed. Of 151 patients underwent a treadmil exercise test, negative result was seen in 134 patients(88.8%) and positive result was in 17 patients(11.2%). Of 17 patients saw positive result, exercise-induced ST segment elevation was present in 4 patients(2.6%) and ST segment depression was seen in 13 patients(8.6%). There was not a significant relationship between the ST segment response to exercise and the clinical variables(diabetes, hypertension, obesity, total cholesterol, current smoking, effort angina, clinical diagnosis, and degree of stenosis) assessed. Of 4 patients with ST segment elevation in treadmil exercise test, 1 patient with ST segment elevation in Ⅰ,Ⅲ,aVF had spasm in right coronary artery(100%) on coronary angiography, of 2 patients in V2-V4 had spasm in left anterior descending coronary artery in 1 patient(50%) and 1 patient in V5-V6 had spasm in left circumflex artery(100%). Positive treadmil exercise test was present in 11.2% of variant angina patient. If we have negative treadmil exercise result in patients with clinical manifestation of unstable angina at admission, we may have a suspicion of variant angina rather than multi-vessel disease. If we have exercise-induced ST segment elevation in patients with clinical manifestation of unstable angina at admission, we have a suspicion of variant angina rather than multi-vessel disease. Our result suggests that the correlation between the site of the ST segment elevation and the artery involved is quite good.

관상동맥 질환에서 SDF-1α의 농도

김보영,박용규,박형서,노상필,정승현,이유선,이정우,이재환,최시완,정진옥,성인환 충남대학교 의과대학 의학연구소 2003 충남의대잡지 Vol.30 No.1

Atherosclerosis is now viewed as an inflammatory disease of the vascular system. Expression of several chemokines, including monocyte chemoattractant protein(MCP)-1, MCP-4, RANTES(regulated on activation normal T-cell expressed and secreted), and interleukin-8(IL-8) are increased in human atherosclerotic plaques compared with normal vessels. They are involved in the pathogenesis of atherosclerosis and plaque rupture by activating and directing leukocytes into the atherosclerotic lesions. However, some are involved in homeostatic functions such as normal leukocyte traffic and growth regulation. SDF-la is a multi-functional cytokine that is involved in myelogenesis, hematopoiesis, angiogenesis and injured gastric mucosal regeneration in the gastric ulcer patient. SDF-la is recently shown to be highly expressed in atherosclerotic plaques and a potent platelet agonist. At least in high concentrations, SDF-la may mediate antiinflammatory and matrix stabilizing effects in unstable angina. Many studies are going on to know the function of SDF-la in coronary artery diseases. I investigated the difference of the plasma level of SDF-la between control group and coronary artery disease group. Total 75 subjects were enrolled. The diagnosis of coronary artery disease was confirmed in all patients by coronary angiography. Control subjects in this study were confirmed normal by coronary angiography. Clinical profile and risk factors were also reviewed. Control subjects in this study were 27 (M=10, F=17). Plasma for the study was collected before the angiography and centrifuged. SDF-la analysis was performed by ELISA. Plasma level of SDF-la is significantly increased in patients with stable angina(n=20) and unstable angina group(n=28) compared with healthy control group(n=27). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases. In this study, plasma level of SDF-la is increased in patients with stable angina and unstable angina groups compared with healthy control group(P<0.05). the risk factors do not influence the plasma level of SDF-la in coronary artery diseases.

다발성 대장암 간전이 환자의 간절제를 위한 새로운 시도

주종우,김형철,임철완,신응진,조규석,유기원,송옥평,홍대식,박성진,조준희,이혜경,김희경,권계원,고은석 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Multiple bilobar liver matastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). A laparoscopic assisted anterior resection was primarily performed. We performed the 1^(st) stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion ballon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1^(st) hepatectomy. A right hepatectomy was safely performed 22 days after the 1^(st) hepatectomy. The patient received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 4 months, then received 9 cycles of systemic chemotherapy (biweekly Oxaliplation, leucovorin, plus 5-fluorouracil) without any recurrence evidence.